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<!doctype html>
<html>
    <head>
        <meta charset="UTF-8">
        <meta name="viewport"
              content="width=device-width, user-scalable=no, initial-scale=1.0, maximum-scale=1.0, minimum-scale=1.0">
        <meta http-equiv="X-UA-Compatible" content="ie=edge">
        <title>挂号新增</title>
        <link rel="stylesheet" href="/res/css/AddReg.css" type="text/css"/>
    </head>
    <body>
        <p>门诊挂号</p>
        <div class="div1">

            <form action="/AddReg" method="post">
                <table border="0">
                    <tr>
                        <td class="t1">挂号单编号</td>
                        <td><input type="text" name="bh"/></td>
                        <td class="t1">门诊类型</td>
                        <td>
                            <select id="s1" name="RegType">
                                <option value="普通门诊">普通门诊</option>
                                <option value="急诊">急诊</option>
                                <option value="专家门诊">专家门诊</option>
                            </select></td>
                    </tr>
                    <tr>
                        <td class="t1">就诊卡号</td>
                        <td><input type="text" name="CardID"/></td>
                        <td class="t1">姓名</td>
                        <td><input type="text" name="Name"/></td>
                    </tr>
                    <tr>
                        <td class="t1">性别</td>
                        <td><input type="radio" name="Gender" checked="checked" value="男"/>男
                            <input type="radio" name="Gender" value="女"/>女
                        </td>
                        <td class="t1">年龄</td>
                        <td><input type="text" name="Age"/></td>
                    </tr>
                    <tr>
                        <td class="t1">挂号科室</td>
                        <td>
                            <select id="s2" name="DepName">
                                <option value="103001">呼吸内科门诊</option>
                                <option value="103002">消化内科门诊</option>
                                <option value="103003">神经内科门诊</option>
                                <option value="103004">心血管内科门诊</option>
                                <option value="103005">血液内科门诊</option>
                                <option value="103006">肾病学门诊</option>
                                <option value="103007">内分泌门诊</option>
                                <option value="103008">免疫学门诊</option>
                                <option value="103009">变态反应门诊</option>
                                <option value="103010">老年病门诊</option>
                                <option value="103011">性传播疾病专业</option>
                            </select>
                        </td>
                        <td class="t1">挂号类型</td>
                        <td>
                            <select id="s3" name="Department">
                                <option value="专家教授">专家教授</option>
                                <option value="普通急诊">普通急诊</option>
                            </select>
                        </td>
                    </tr>
                    <tr>
                        <td class="t1">就诊医生</td>
                        <td><input type="text" name="DoctorName"/></td>
                        <td class="t1">挂号时间</td>
                        <td><input type="date" name="RegDate"/></td>
                    </tr>
                    <tr>
                        <td class="t1">操作人员</td>
                        <td colspan="3"><input type="text" name="Operator"/></td>
                    </tr>
                </table>
                <div class="div1">
                    <input type="submit" value="提交"/>
                    <input type="button" value="打印"/>
                </div>
            </form>
        </div>
    </body>
</html>